• Getting pregnant
• Miscarriage
• Fertility

Miscarriage: the complete guide

Miscarriage is the most common complication of pregnancy, affecting 10-15% of pregnant women. In the event of a miscarriage, it is important to consult a doctor quickly. But what are the signs of a miscarriage? How do you deal with it? What are the solutions? We answer these questions through this comprehensive guide.

What is a miscarriage?

A miscarriage, or spontaneous abortion, is an event that results in the loss of a fetus before 20 weeks of pregnancy. It usually occurs during the first trimester, or the first five months of pregnancy. Miscarriages can occur for a variety of medical reasons, many of which are not controllable. But knowing the risk factors, signs and causes can help you better understand the event and get any support or treatment you may need.It is important to note that genetics and miscarriage are not necessarily related. Just because your mother had a miscarriage doesn't mean that you will have one.

Signs of miscarriage

The symptoms of a miscarriage vary according to the stage of pregnancy. In some cases, it happens before you know you are pregnant.The main symptoms of a miscarriage are :

• cramping
• vomiting
• vaginal bleeding
• discharge of vaginal tissue or fluid
• severe abdominal pain or cramps
• mild to severe back pain
• the disappearance of signs of pregnancy (swollen breasts, nausea, etc.)

If one or more of these symptoms are present, it is important to contact a health care professional as soon as possible so that your doctor or midwife can carry out tests and diagnose a possible miscarriage.

Causes of miscarriage

During pregnancy, your body supplies hormones to your developing fetus to help it develop. Most first trimester miscarriages occur because the fetus is not developing properly. They are the result of genetic abnormalities that occur during the first cell divisions after fertilization. Exercise and sexual intercourse do not cause miscarriages, nor does work, unless you are exposed to harmful chemicals or radiation. However, the following conditions can interfere with the development of the fetus:

• poor nutrition or malnutrition
• drug and alcohol use
• advanced maternal age
• untreated thyroid disease
• hormone problems
• uncontrolled diabetes
• infections
• trauma
• obesity
• cervical abnormalities (such as a gap in the cervix)
• an abnormally shaped uterus
• severe high blood pressure
• food poisoning
• certain drugs

Always check with your doctor before taking any medicine to make sure it is safe during pregnancy.

Miscarriage or menstruation?

Often, a miscarriage can occur before you even know you are pregnant. Also, as with menstruation, some of the symptoms of a miscarriage are bleeding and cramping. In early pregnancy, it's not always easy to tell the difference between a miscarriage and menstruation.To distinguish between them, several factors must be taken into account:

• Symptoms: Severe or worsening back or abdominal pain or blood clots can cause a miscarriage.
• Time: Miscarriage very early in pregnancy can be mistaken for menstruation. However, this risk is less after eight weeks of pregnancy.
• Duration of symptoms: Symptoms of a miscarriage usually worsen and last over time, unlike menstruation.

Miscarriage statistics

Sometimes the cause of a miscarriage remains unknown. However, the Mayo Clinic estimates that about 50% of miscarriages are due to chromosomal problems.According to the 2005 Franco-American study conducted by the team of Rémy Slama and Jean Bouyer, American Journal of Epidemiology, the risk of miscarriage increases by 30% when the future father is over 35 years old.

A miscarriage does not mean that you will not have a baby. According to the Cleveland Clinic, 87% of women who have had a miscarriage will continue to carry a child to term. Only about 1% of women have three or more miscarriages.

Types of Miscarriages

There are many types of miscarriages. Depending on your symptoms and the stage of your pregnancy, your doctor will diagnose one of the following:

• Complete Miscarriage: All of the pregnancy tissue has been expelled from your body.
• Incomplete miscarriage: you have evacuated tissue or placental material, but there is still some in your uterus.
• Missed miscarriage: the fetus is no longer viable and signs of pregnancy disappear but there is no spontaneous evacuation.
• Threat of miscarriage: bleeding and cramping indicate a possible miscarriage.
• Inevitable miscarriage: bleeding, cramping and dilation of the cervix indicate that a miscarriage is inevitable.
• Septic miscarriage: due to the fact that there are still residues of cells inside the uterus that have become infected.

Prevention of miscarriage

Not all miscarriages can be prevented. However, there are steps you can take to help maintain a healthy pregnancy. Here are some recommendations:

• Receive regular prenatal care throughout your pregnancy.
• Avoid alcohol, drugs and tobacco during your pregnancy.
• Maintain a healthy weight before and during pregnancy.
• Avoid getting a virus. Wash your hands thoroughly and stay away from people who are sick.
• Limit caffeine to no more than 200 milligrams a day.
• Take prenatal vitamins
• Eat a healthy, balanced diet with plenty of fruit and vegetables.

Remember that a miscarriage does not mean that you will not conceive in the future. Most women who have a miscarriage carry a pregnancy to term afterwards.

Miscarriage treatment

The treatment you receive for a miscarriage may depend on the type of miscarriage you have had. If there is no pregnancy tissue left in your body (complete miscarriage), no treatment is necessary.If there is tissue left in your body, there are several treatment options:

• Waiting for the remaining tissue to pass naturally out of your body
• Medical management, which consists of taking medication to help you remove the remaining tissue.
• Surgical management, which consists of having any remaining tissue surgically removed.

The risk of complications from any of these treatment options is very low and the decision about treatment will be made with your doctor. It is not necessarily necessary to perform a curettage after a miscarriage. This will be indicated by a follow-up ultrasound. However, if the expulsion is incomplete, you will have to take tablets to get rid of the rest. Finally, the doctor may also use suction (to empty the uterus) or a curettage (to scrape out the mucous membrane). Both operations are performed under general anaesthesia.

Physical recovery

After a miscarriage, you may experience symptoms such as cramps and abdominal pain. Although pregnancy hormones can remain in the blood for a few months after a miscarriage, you should return to normal menstruation after four to six weeks. Avoid having sex or using tampons for at least two weeks after a miscarriage.

Support after a miscarriage

It is normal to experience a wide range of emotions after a miscarriage. You may also experience symptoms such as trouble sleeping, lack of energy and frequent crying. Take your time to grieve and ask for help when you need it. You may also want to consider the following:

• Ask for help if you feel overwhelmed or too sad. Your family and friends may not understand how you are feeling, so let them know how they can help.
• Keep all baby memories, maternity clothes and baby items until you are ready to see them again.
• Make a symbolic gesture that can help you remember. Some women plant a tree, keep a picture of the ultrasound or wear special jewelry.
• Ask a therapist for advice. Grief counsellors can help you deal with feelings of depression, loss or guilt.- Join a focus group to talk with others who have been through the same situation. This will help you feel supported and better understood.

Getting pregnant again

After a miscarriage, it is a good idea to wait until you are physically and emotionally ready before trying to conceive again. You can ask your doctor or midwife to guide or help you develop a conception plan before trying to get pregnant again.